MATERIALS AND METHODS: The imaging studies for 12 patients with biopsy-proven hepatic tuberculosis from January 2012 till March 2014 were reviewed retrospectively. These cases were confirmed via ultrasound-guided biopsy.
RESULTS: The patients were aged 24-72 years. Four patients had parenchymal tuberculosis only and eight patients had mixed parenchymal and biliary duct involvement. The parenchymal tuberculosis patients showed poorly enhancing, hypodense nodules on CT with central calcification and adjacent dilated intrahepatic ducts. Most patients had multiple lesions except for two patients with a single lesion. The size of the lesions ranged from 0.5 to 6 cm. Seven patients with biliary duct involvement showed a hilar strictures involving the intrahepatic ducts and common bile duct. Nine of the patients showed hilar stricture with atrophy of the ipsilateral lobe of the liver and compensatory hypertrophy of the contralateral lobe. Hepatolithiasis was seen in five patients. Tuberculous lung involvement was seen in seven patients.
CONCLUSION: The presence of calcified and hypodense nodules with biliary duct dilatation associated with lobar atrophy were the most consistent features of hepatic tuberculosis, especially in the presence of active lung disease.
MATERIALS AND PROCEDURES: Between April 2015 and July 2017, 46 embolization treatments for brain arteriovenous malformations (BAVM) were performed in 25 patients using two Squid formulations (18 and 12). Six female and 19 male patients with a mean age of 34 years (range, 9-62 years) were included. A total of 46 procedures were performed. The BAVMs were classified as Spetzler-Martin grade II in 4 procedures, III in 27 procedures, and 1V in 15 procedures. Among the 25 patients, 15 presented with hemorrhage, 5 with seizures, and 5 with headache and neurology. The BAVMs were located in the temporal lobe in 5 patients, parietal lobe in 7 patients, frontal lobe in 3 patients, posterior fossa in 6 patients, basal ganglia in 3 patients, and parasagittal lobe in 1 patient.
RESULTS: The obliteration rate of the BAVMs ranged from 10% to 100%, with a mean of 33%. Most patients underwent their first or second embolization procedure. Four patients (8%) developed intracranial bleeding post-procedure, with one death (2%). One patient (2%) experienced a seizure during the procedure; however, no intracranial bleeding was observed. Seven patients (15%) experienced perforations during catheter manipulation. One case (2%) of a fractured catheter was recorded, but no significant complications were observed. The average volume of copolymer injected was 0.6 ml per nidus. Thirteen procedures used the Squid-12 formulation, 29 procedures used the Squid-18 formulation, and 3 procedures used a combination of Squid-12 and -18 formulations.
CONCLUSION: Squid is a safe and effective embolic agent for treating BAVMs.
METHODS: This prospective, randomised, intervention study was conducted between October 2018 and October 2019 in a tertiary hospital. Overall, 115 patients with ureteral stents that were inserted after lithotripsy surgeries were recruited. The study subjects were randomised into two groups: one group was administered sodium citrate (Utix sachets) three times per day until stent removal (intervention group), and the second group was not administered Utix sachets (control group). Stents were removed after 1 month and inspected under macroscopic visualisation from the proximal to distal end for any crystallisation; a second inspection was done with a 60 × magnification lens. Any crystallisation observed was considered to be encrustation.
RESULTS: Patients who had Utix sachets post-insertion of a ureteric stent constituted 50.4% of the study cohort. The rate of encrustation in the control group was 52.6%. In the intervention group, the rate of encrustation was 46.6%. The difference was not statistically significant with the chi-squared test (p value, 0.514).
CONCLUSION: Alkaline citrate medications had no significant effect on stent encrustation rate. More studies are needed to elucidate different agents and their roles in reducing stent encrustation as it incurs high morbidity.
METHOD: Stereolithography (SLA) 3D Print technology using SLA resin and Anycubic SLA printer were employed. A plastic tubing was used to connect the 3D printed kidney and bladder as the ureter. This simulation model permits fluoroscopic guided filling of "pelvicalyceal system" with contrast as well as ureteric stenting, guidewire and drainage catheter manipulation. Effectiveness of the model to attain skills for nephrostomy exchange and ureteric stenting was obtained via questionnaire from trainees prior to and after utilising the model.
RESULT: The 3D printing simulation model of the kidney, ureter and bladder system enable trainees to perform nephrostomy exchange, nephrostogram and antegrade stenting. Participants felt more confident to perform the procedures as they were more familiar with the procedure. Besides that, participants felt their wire and catheter manipulation skills have improved after using the simulation model.
CONCLUSION: Neph-ex simulation model is safe and effective for hands-on training in improving proficiency of fluoroscopy-guided nephrostomy exchange and antegrade ureteric stenting.